Jessica Raye Wichmann, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAC0628 Issued in ND

Practice address

2650 32ND Ave S Ste D
Grand Forks, ND 58201-6541

Phone

(701) 732-2700

Fax

(701) 732-2701

NPI assigned

Oct 8, 2009

Last updated

Jan 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christian Unity Hospital CorporationGroup PAC ID 8123925401, shared by 4 NPIs, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unity Medical Center Hospital, Grafton, ND, CCN 351320

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christian Unity Hospital Corporation

  dba Unity Medical Center

  • Critical Access Hospital
  • Grafton, ND
  • NPI 1245216852
  Medicare reassignment NPD
• Christian Unity Hospital Corporation

  dba Grafton Family Clinic

  • Rural Health Clinic/Center
  • Grafton, ND
  • NPI 1558423665
  Medicare reassignment NPD
• Aitkin Community Hospital, Inc.

  dba Riverwood Healthcare Center

  • Critical Access Hospital
  • Aitkin, MN
  • NPI 1942277835
  Medicare reassignment NPD
• Warren Community Hospital, Inc.

  dba North Valley Health Center

  • Critical Access Hospital
  • Warren, MN
  • NPI 1073516357
  Medicare reassignment NPD
• Lisbon Area Health Services

  dba CHI Lisbon Health

  • Clinic/Center
  • Lisbon, ND
  • NPI 1811168958
  Medicare reassignment
• Sanford Health Network North

  dba Sanford Health Southeast Campus

  • Multi-Specialty Clinic/Center
  • Thief River Falls, MN
  • NPI 1386047355
  Medicare reassignment
• Sanford Health of Northern Minnesota

  dba Sanford Health Kelliher Clinic

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697
  Medicare reassignment
• Christian Unity Hospital Corporation

  dba Park River Family Clinic

  • Rural Health Clinic/Center
  • Park River, ND
  • NPI 1821637828
  NPD
• Lisbon Area Health Services

  dba CHI Lisbon Health

  • Clinic/Center
  • Lisbon, ND
  • NPI 1184051971
  NPD
• Aitkin Community Hospital, Inc.

  dba Riverwood Pharmacy Aitkin

  • Community/Retail Pharmacy
  • Aitkin, MN
  • NPI 1497377287
  NPD
• Sanford Health Network North

  dba Sanford Wheaton Clinic

  • Rural Health Clinic/Center
  • Wheaton, MN
  • NPI 1245524669
  NPD
• Sanford Health Network North

  dba Sanford Pharmacy Thief River Falls

  • Community/Retail Pharmacy
  • Thief River Falls, MN
  • NPI 1346423373
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christian Unity Hospital Corporation

  dba Unity Medical Center

  • Critical Access Hospital
  • Grafton, ND
  • NPI 1245216852
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1326373317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5210",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582065210",
            "telephone_number": "218-310-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 32ND AVE S STE D",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016541",
            "telephone_number": "701-732-2700",
            "fax_number": "701-732-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMANN",
        "first_name": "JESSICA",
        "middle_name": "RAYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0628",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10660",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467147",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "970004432",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica C White Plume, PH.D., M.P.H.
• Amber White
• Elle White
• Kelly Lynn White, LAC
• Kristi Rae Whiteside
• Sharon P Wick, CRNA
• Erica Wiechert
• Erica L Wiegandt, O.D.
• Mary D Wiersma, RN
• Devlin Ann Wiest, LAT, ATC

• Physician Assistant in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.